A 65-year-old male weighing 70 kg with no history of interest presented to our hospital for TURP.
For a year and a half, the patient presented symptoms of prostitute syndrome.
He was studied by the Urology Department and was diagnosed with benign prostatic hypertrophy.
Preoperative examination showed no abnormalities (electrocardiogram, blood count and biochemistry normal).
She's scheduled for TUR.
No premedication was performed.
Intraspinal anesthesia is performed with the patient in the sitting position.
Before induction of anesthesia, continuous electrocardiogram (ECG), noninvasive blood pressure (BP), and SpO2 were monitored.
The intervention lasted 60 minutes and was uneventful.
During the procedure, 3.5 sterile water (hypotonic) was administered as irrigation fluid, with a negative balance of 1500ml.
Vomiting and hypotension (100/60mmHg) were present in the awakening room.
No neurological, cardiovascular or pulmonary edema alterations were observed.
ECG and X-ray showed no abnormalities.
In the blood biochemistry highlighted: sodium: 122 mEq/L, potassium: 5.9 mmol/L, osmolarity : 256 mOsmol/kg, urea: 1.5 g/L, total platelets: 288.820 U:
Gas pH: 7.30; PCO2 : 36 mmHg; PO2 : 72 mmHg.
The patient was admitted to the resuscitation unit.
After clinical stabilization of blood pressure, standardization of vasopressive drugs was achieved, Furosemide IV and hypertonic saline 3% were administered to minimize volume overload.
Despite the measures applied, acute oliguric renal failure persisted for 15 days, reaching maximum levels of urea of 2.70 g/L and creatinine of 72 mg/L, requiring 04 hemodialysis sessions.
At 3 weeks, diuresis resumed and the patient entered the polyuric phase, progressively recovering renal function, with Cr.s. at discharge of 14 mg/L. At 4 months, Cr levels remained normal.
10 mg/ L and a Ccr.
76 ml/minute.
